1. Analysis of the pathogenesis and diagnostic typing The knee is the capital of the tendons and is tied to the three meridians of the liver, kidney and spleen. The liver collects blood, the tendons, the kidney collects essence, the bones, and the spleen transports and transforms the flesh. Osteoarthritis of the knee joint occurs mostly in middle-aged and elderly people, 7-8 in men and 7-7 in women, with gradual loss of liver and kidney, and slackening of tendons and bones; tendons without blood nourishment are not flexible; bones without marrow nourishment are not strong; flesh without spleen mastery is weak and feeble, with insufficient qi and blood and loss of harmony of veins and channels, resulting in tendons without bones and knees without slippage, and the onset of various diseases. This is the intrinsic factor of this disease. On the basis of this understanding, Professor Liu Yu divided the disease into three types: liver and kidney deficiency, cold and dampness paralysis and phlegm and blood stasis. The main clinical manifestations are pain in the knee joint, local enlargement, stiffness and deformity, thin muscles, unfavorable flexion and extension, aversion to cold and warmth, lack of warmth in the hands and feet, soreness and weakness in the waist and knees, swelling of the knee joint, restriction of flexion and extension, unchanged skin color, slightly elevated local skin temperature, pain around the joint, extensive pressure on the tongue, red or light. Extensive pressure pain around the joint, red or pale tongue, thin white fur, sunken and thin pulse. Cold and dampness paralysis is mostly due to long-term strain and injury, the couples are empty, wind, cold and dampness are mixed, stagnating the blood vessels, and the two knee veins are blocked, resulting in heavy pain and delayed healing. The main clinical manifestations are painful weakness of the knee joint, aggravated by activity and cold, and reduced after rest, the pain is episodic at the beginning of the disease, later the pain interval is gradually shortened, the attack time is gradually prolonged, and finally the pain attack is continuous, and both knees are atrophied and soft, fearing cold and preferring warmth, getting warm is comfortable, walking is easy to fall. The examination shows no swelling of the knee joint, normal activity, low skin temperature, peripatellar or medial and lateral knee pressure pain, and no abnormalities in the moss and pulse. The phlegm and blood stasis type is a long-standing disease, with loss of harmony between qi and blood, inaccessibility of the veins and channels, and phlegm condensation as phlegm, with the phlegm and blood stasis intertwined, penetrating into the bones and organs. The main manifestations are swelling and pain in the knee joints, difficulty in walking, obvious limping, and inability to squat. On examination, we see swelling of the knee joint, limited flexion and extension, unchanged skin color, slightly high local skin temperature, extensive pressure pain around the joint, and positive floating patella test. The tongue is pale with thin and smooth coating, and the pulse is moist and thin. (1) Chinese herbal medicine for the treatment of liver and kidney deficiency The treatment should be to tonify the liver and kidney, strengthen the tendons and bones, dispel dampness and open the channels. Liu Lao formulated his own formula to tonify the kidney and strengthen the bones: 10g of deer horn gum, 9g of raw and ripe ground, 15g of Epimedium, 15g of Dulcis, 9g of Cornu Cervi Pantotrichum, 15g of Sambucus, 15g of Eucommia, 9g of Dampness, 10g of Zedoary, 6g of Niubizi, 10g of Radix Angelicae Sinensis, 10g of Salviae Miltiorrhizae, 10g of Radix et Rhizoma Glycyrrhizae. The main herbs are Du Zhong, Sang Sang Sang and Cornu Cervi Pantotrichum to nourish Kidney-Yin, supplemented by Dan Pi and Ze Xie to clear the excess fire to prevent excessive nourishment and greasiness, and Ox Knee to induce downward movement of fire, Angelica Sinensis and Salviae to nourish Blood and harmonize the ligaments. The treatment should be to warm the kidney and nourish the liver to strengthen the tendons and bones, dispel cold and dampness and stop paralysis. The medicine used in this study is P.E.S. 10g, Cornu Cervi Pantotrichum 10g, Tien Ma 10g, Hsiang Xin 6g, Gui Zhi 10g, Dog Chi 10g, Fu Ling 12g, Coix Seed 15g, Fried Atractylodes Macrocephalae 10g, Mu Xiang 10g, Ze Di 10g, Sheng Gan Cao 10g. The “Nei Jing” says: “Wind, cold, and dampness are combined to form paralysis. However, “if the righteousness exists within, the evil cannot dry up”. Insufficient Yang Qi, lack of harmony between the Ying and the Wei, wind, cold and dampness attack, paralyzing the muscle couples and limbs, and blocking the veins, resulting in pain. Most of the knee pains seen in clinical practice are prolonged and recurrent, most of them are afraid of cold and prefer warmth, and are relieved by warmth. This formula is based on Pieces of Pith and Cinnamomum to benefit the kidney and help Yang, promote paralysis and disperse cold, warm the meridians and open the ligaments. The treatment is to resolve phlegm and dampness, warm the meridians and open the channels. Liu Lao formulated ErTeng Tang, using LeigongTeng 10g, Chicken Blood Vine 10g, Nanxing 12g, DiLong 10g, QiangWu 10g, XianLingSpleen 10g, Fried BaiShu 10g, Angelica sinensis 10g, DanShen 10g, raw Coix Seed 15g, White Poria 12g, raw Glycyrrhiza glabra 10g. Chicken Blood Vine is the main medicine to relieve pain and remove paralysis; adjuvant with Nanxing, BaiShu and DiLong to dry dampness and strengthen spleen, resolve phlegm and eliminate swelling; Poria, raw The herbs are complemented by Fu Ling and raw Coix Seed, which are used to promote dampness and strengthen the spleen; Qiang Wu and Xian Ling Spleen to dispel wind and promote paralysis; Angelica Sinensis and Danshen to nourish blood and harmonize blood circulation; and Sheng Gan Cao to harmonize the herbs. (2) Topical treatment with Chinese herbal medicine: 15g each of Liu Fan Nu, Dou Wu, Gentiana Macrophyllae, Chuan Bu, Chuan Wu, Cao Wu, Rhubarb, Pepper, White Herba, Ginger, Safflower, Camphor, 10g each of ice chips, 3g of ice chips, 30g of Huang Dan, Xie Zhi Cao, 20g each of Mugwort, Angelica, Sang Sang Sang, Niubizi, Method: Add 30g of small pieces of green onion, mix with 400ml of edible vinegar, and wrap with 2 gauze bags. Wrap it well (loose, easy to wrap the knee joint), put it in a pot and steam for 20 min, then put it on the surface of the patella for hot compress (to prevent local burns, at the beginning, put a towel on the surface of the knee joint until the drug is warm, then remove it; to prevent the drug from dissipating too quickly, wrap a small quilt locally after compressing the drug), the two bags can be used alternately for 30-50 min each time, once in the morning and once in the evening, each dose Each dose of medicine can be used for 2d, 10d is a course of treatment. 3, functional exercise As soon as osteoarthritis of the knee occurs, it is not only difficult to cure, and can gradually aggravate, affecting the normal life of the elderly. Liu believes that the acute phase should be based on internal Chinese medicine and bed rest; the chronic phase should be properly exercised to strengthen the muscles and bones and smooth the joints. Exercises can be done in sitting and lying position. The knee does not bear weight when sitting and lying down, which is simple and comfortable, and is suitable for middle-aged and elderly people with weak constitution, including the following ways. The methods are ① Grinding and pushing the patella: First, use the palm of the hand to rub the patella in clockwise circles around the patella until the skin is warm, then pinch the patella with the index finger of the thumb of one hand and push and lift it upward and inward to increase the mobility of the patella. ②Straight leg elevation: the patient lies on his back and elevates the affected knee in the straight position by 30-40 cm, the quadriceps muscle is contracted with force, trying to maintain this position, and when it is not possible to hold on, it can be put down to rest. (3) Weighted straight leg raise: the same action as above, but in the raised calf burdened with a certain amount of weight, starting from 1kg, gradually increasing to 5kg. the above methods, each time a total of 5 to 10 minutes of exercise, every day in the morning and evening, and can increase the number of exercises as appropriate. After clinical observation, patients with good cooperation can effectively reduce symptoms and prevent recurrence. 4, health education and conditioning Because the disease is quite troublesome to treat once it occurs, Liu paid special attention to the prevention and early treatment of the disease, the anatomical characteristics of the knee joint is “skin and bone”, the surrounding soft tissue cover less, vulnerable to cold attack. Cold is the initial cause of osteoarthritis, so keeping warm is the best way to prevent this disease. Secondly, patients are warned to pay attention to weight control to reduce the burden on the joints, which is extremely important to slow down the development of osteoarthritis.